PracticePrompt Blog

What a Pain! 3-year on follow-up comments on hand problems

Posted in Deliberate Practice by elwynrees on December 6, 2012

Wow how time flies!   It’s almost 3 years ago I started getting numbness and strange sensations in my left hand pinky.  Over the next few months (early 2010) the condition worsened.  I wrote an entry about it then What a pain in the… this describes typical “hand” issues: cubital tunnel, carpal tunnel, epicondylitis and nerve problems with the ulna nerve.   The post also has some YouTube videos of exercises that I found researching the problem.

So have have things progressed?

It all started when I was practicing the left hand for a piece I was studying.   Although, I do remember banging my elbow at the time.  At first  I noticed a sensation (not even numbness) in my left little pinky, a bit like having one finger of a surgical glove on.  However, this soon progressed to involve both the pinky, and the adjacent half of the ring-finger.  This then changed into full blown numbness.  There was never any discomfort or pain in the hand (but some tenderness in the elbow).     These are all characteristic of ulna nerve entrapment or compression.

During the early part of 2010, things got so bad that I effectively stopped playing for several months.   The first line of attack is to ice and rest.   Applying an ice pack to the elbow several times a day greatly helped.  By this time the 4th and 5th fingers felt dead.   Now as an aside, I’d already had some rotator cuff shoulder issues with the left arm (I’m left handed).     At night I started using a towel wrapped around my arm to keep it straight.   I also started doing the exercises (see the videos in the post linked at the top).     Over the next few months there was gradual improvement and I started practicing again.   However, work on any “challenging” pieces went right out the window.

I decided to take a ‘Change of Tack‘  and focus on sight-reading, this opened a new chapter for me.  I’d always been a decoder & decypherer  (sight-reading was something I never did with my piano teacher).   I’d also logged how many hours it was taking to learn the “Challenging” (well for me!) pieces (20 to 80+ hours).   I thought that by improving my sight-reading, the time to study the Challenging pieces would reduce (well it seems logical).   As always nothing runs true to form!

Playing large numbers of simple pieces showed that there were still significant technical problems with my left hand (lack of dexterity, strength, independence and general clumsiness in my left hand).   I found that even short 16 th notes runs were very poor.   So another great diversion then took place away from Sight-Reading to “Technique”.

The work on Technique initially focussed on scales.  I hoped that these would improve my 16th notes and so decided to practice scales systematically around the circle of fifths.   I completed 60 plus cycles.  I’d spend 5 minutes per scale, and did both hands separate and hands together practice in quarter notes (1 octave), eighth notes (2-octaves) in legato, staccato and swing rhythms.   I worked in sets of major and their relative minors (1 set a day = 15 minutes and  2 weeks to comptlete a cycle.  Two sets = 30 minutes and 1 week to complete a cycle).     I started off at a modest tempo and increased gradually to around 104.   For me the higher tempos felt very forced.   However, the fifth finger in particular wasn’t getting much of  workout, and the left hand fifths and fourths weren’t getting the focus they needed.

So if a “drawback” of scales is their simple linear approach (and little use of the pinky), I thought I needed other exercises to support the scale work.   I wanted to vary the sequence of fingers, I read somewhere that “Hanon No. 5 was good for the 4th and 5th fingers and so started work on just this one.   This was a slippery slope!   I started working through the rest using a similar practice regimen to that described above for scales.  I know that there’s much written about the pros and cons of Hanon, but the bottom line is I enjoy practicing them.

Progress has been slow, but the 4th and 5th fingers of the left hand have continued to be a problem.  Whilst reduced, the numbness still largely remained, but did improve with time.

Two things bothered me, firstly progress was slow, numbness and dexterity weren’t improving.    So earlier this year I started to think of additional ways to improve the 4th and 5th.   I have a copy of Richard Meyrick’s Finger Exercises (a 15 minute work out in 3 grades).  I’d used them for a while but stopped about 3 years ago (is there a link?).   Secondly, I was bothered that for a large number of scales, at the end of each practice session they were usually going OK, but for a number, I was struggling at the start just to get the notes right (playing these from memory).

To deal with the first issue I started researching further piano exercises and away from piano techniques.   For the second, I’ve largely stopped playing Scales and Hanon through stepped tempos and now just play the 16th notes ‘cold’ at tempo (although now much reduced from 100).  The aim being fluency.

The most thorough approach I could find to studying technique and musicianship is that detailed on Pebber Brown’s web site.  He’s a guitar teacher of some note.  He has developed a large number of highly detailed exercises for picking and fretboard work.   I found Pebber’s You Tube videos inspiring.   Check out his “Spider” and “Ladder” fret board examples.   Also of note is the approach to improving trills which in essence has an element of “No pain no gain” about it.    It appears to me that it’s a very direct in your face logical approach.  So I decided to develop a few simple exercises based on this approach for piano.   For example, if the 4th and 5th fingers are weak play a lot of 4th and 5th fingers.    What I do for these in my left hand is to firstly: set a metronome going at a modest tempo. Hold down G, then play Cs with the 5th finger in sets of quarter, eighth, triplets and sixteenth notes, repeating each several times so that the whole pattern takes nearly a minute, then repeat but this time using the 4th on D (with G held).  I then repeat this holding down both F and G.   I then repeat this but alternating between the 4th and 5th.   The whole of this exercise takes 5 minutes.

The Richard Meyrick exercises also revealed a 4th and 5th finger left hand problem: playing thirds (5-3 to 2-4).   So I’ve taken a direct approach with these and have introduced both 1 minute and 2 minute drills (see any recent captain’s log entry!).   These confirm the much lower ability of the left-hand.

I still felt that more needed to be done.   I found Paul Barton’s recent advanced tutorial on Chopin’s Etude Op 10 No 4.   This has the concept of micro-studies.   Paul has produced nealry 30  studies derived from phrases in the etude and gives examples of how to go about practicing them.  I’ve now added several of these to my daily workout.  A number of these are runs that feature the 4th finger which gets a hec of a workout even at modest tempos.

Another significant observation about the left hand issues is that in July, I started going to the gym (again).  That is the gym above.  I try to get there several times a week, often first thing on Saturday.   I use 4 cardio (bike, stepper, cross-trainer and treadmill) and between each of these I do a couple of sets on arm/upper torso machines.   I often practice shortly after returning from the gym and started noting a pattern where the Hanon, Scales and exercises would go particularly well when practiced after the gym session.    So staying fit and health is very wise!  Subjectively, I think this has helped greatly.

So far, this seems to be a long dark tunnel with little light glowing at the far end.    Since adding in the additional studies this year and the Chopin micro-studies several weeks ago, I have noticed further improvement.   But most recently, I’ve discovered a unique form of hand exerciser the “Stress Banana ” – this was given to me as a joke.   But during the recent weeks, I’ve found it very beneficial when away from the piano to practice flexion of all fingers and the 4th and 5th in particular against it’s gently squisshy resistance.  Last week I’ve started taking it to work and using it when time permits.   There are a number of hand exercisers available, including balls and knuckle duster style gadgets, but the banana shape seems highly suitable (a bit like a small maleable fret board?).   You can also vary the resistence by clamping down on it away from the finger being exercised.

Currently, the numbness is at it’s lowest level in several years, similarly, the finger strength and dexterity at it’s greatest.    The current state of play is that the left hand issues have greatly improved in recent weeks.   I remain very hopeful that if I keep up the regimen of practice and physical drills and exercise that there will be continual improvement.

Here’s some images of the Stress Banana (and no, it’s not my mit):


One Response

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  1. ck said, on December 18, 2012 at 03:35

    I can imagine how much time you have spent on the internet doing research because there is so much information (and myth) about this out there. I used to play the piano but stopped when all my repetitive stress injuries worsen. I did a lot of research too and at this point seem to find the “Feldenkrais Method” very helpful. You may check it out to get another angle of the situation.

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